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ESTRO 35 2016 S683

________________________________________________________________________________

analysis with more advanced RT technique is needed to

assess the future role of RT in orbital tumors.

EP-1476

General fatigue during the period of radiotherapy; clinical

usefulness of Japanese herbal medicine.

N. Yoshikawa

1

Osaka Medical College, Radiology, Takatsuki, Japan

1

, H. Yoshioka

1

, K. Yoshida

1

, T. Shimbo

1

, Y.

Uesugi

1

, Y. Narumi

1

Purpose or Objective:

Breast cancer patients receiving post-

operative radiotherapy (RT) experience adverse effects and

general fatigue is one of them. Although it is often not severe

enough to interrupt the course of RT, it negatively affects

quality of life. Some Japanese herbal medicines such as TJ-41

(Hochu-ekki-to) are effective for fatigue and are often used

in daily practice. The purpose of this study is to assess

radiation-induced fatigue (RIF) in detail and investigate the

effect of Japanese herbal medicine.

Material and Methods:

Breast cancer patients who received

post-operative RT and agreed to answer a patient self-

reporting questionnaire (FACIT-F; Functional Assessment of

Chronic Illness Therapy) were eligible for this study. We

excluded patients who were receiving chemotherapy

concurrently. RIF was defined as fatigue which occurred

during the period of radiotherapy and there were no causes

for the fatigue other than the radiotherapy. The FACIT-F

questionnaire was answered before RT, at one week after the

beginning of RT, at the end of RT and one month after the

end of RT. We prescribed TJ-41 to the RIF patients during the

radiotherapy. We defined as responders the patients who

experienced improvements in RIF and hoped for further

prescription.

Results:

Fifty-two patients were enrolled for this study. RIF

was observed in 24 (46 %) patients. On univariate analysis,

the statistically significant predictor of RIF was the score of

FACIT-F before RT. TJ-41 was administered to 9 patients and

8 of them (89 %) were responders.

Conclusion:

RIF was common in breast cancer patients

receiving post-operative RT and TJ-41 was effective for the

RIF patients and improved their quality of life. However,

these results may lack objectivity and the study was

conducted with no placebo group. Improvement in objectivity

of the assessment and a comparative study will be needed.

EP-1477

Radiotherapy-Hyperthermia: outcome/toxicity in the

superficial recurrent/metastatic tumors

E. Garibaldi

1

Istituto di Candiolo- IRCCS, Department of Radiotherapy and

Radiation Oncology, Candiolo, Italy

1

, A. Di Dia

2

, E. Delmastro

1

, G. Belli

1

, M. Gatti

1

,

G. Cattari

1

, A. Salatino

1

, S. Squintu

1

, M. Poli

2

, A. Miranti

2

, P.

Gabriele

1

2

Istituto di Candiolo-IRCCS, Medical Physics, Candiolo, Italy

Purpose or Objective:

Hyperthermia is a powerful

radiosensitizer for treatment of superficial tumors. Several

trials showed an advantage of combining radiotherapy with

hyperthermia in terms of both local tumor control and overall

survival. The purpose of this study is to evaluate both

efficacy and toxicity of radiotherapy-hyperthermia (RT-HT) in

the treatment of superficial recurrent and metastatic tumors

in patients previously or not previously irradiated.

Material and Methods:

In our Institution twenty-three

patients (mean age 71,4 years; range: 51-88) with

histologically confirmed superficial recurrent/metastatic

tumors were enrolled: 11 breast carcinoma, 6 head&neck

cancer, 2 malignant melanoma, 2 sarcomas, 1 uterine

adenocarcinoma and 1 hepatocarcinoma. Patients underwent

radiotherapy treatment using 3D-conformal radiotherapy

(8/23) or Helical Tomotherapy (15/23). External beam

radiotherapy was delivered in 6-27 fractions of 1.8-5 Gy for a

total dose of 20-57.5 Gy (mean external dose: 41 Gy).

Prescribed dose was established taken into account, of the

previous radiation doses, in previously irradiated patients,

Karnofsky performance status and patient compliance.

Hyperthermia treatment was performed with an

electromagnetic superficial applicator operating at the

frequency of 434 MHz. HT session was delivered once/twice

weekly during the period of external radiotherapy, 1-2 hours

after radiotherapy, to a mean total of 5 treatments [range:

1-9 sessions]. Termocouples were used to evaluate

temperature distribution map. Average, maximum and

minimum temperature parameters were recorded during

hyperthermia treatment. The treatment goal was to reach

40- 42°C in > 90% (T90) of measured points for a duration of

60 minutes. Acute and late toxicity was evaluated according

to the CTCAE criteria. Local control was assessed after the

end of the treatment on the basis of the RECIST Criteria.

Results:

During hyperthermia treatment the median

temperature reached was 40.5 °C [range: 39 – 42.9°C].

During the radiotherapy in association with hyperthermia 2

pts (10%) had G3 toxicity and one of these interrupted the

treatment. One pt had acute cutaneous toxicity ≥ G3 at 1

month. No pts had toxicity ≥ G2 at 3 and 6 months. No

toxicity was observed at 12 months. The mean follow-up was

10 months (range 3-22 months). Four pts (17%) had a

complete response (CR), 11 pts ( 48%) had a partial response

(PR),7 pts (30%) had a stable disease, (SD) and only 1 pt (4%)

had progression disease (PD) and subsequently died. The

Local control rate was 95%. Univariate analysis showed that

Tmean,Tmax, Tmin,T90 parameters were not associated with

local control rate.

Conclusion:

Radio-hyperthermia can result in an effective

approach, particularly in previously irradiated patients or in

radio-resistant tumors. Our results show that Radio-

Hyperthermia is an useful combined treatment with a good

local control rate and a very high patient compliance.

EP-1478

Low Dose Radiation therapy of degenerative painful

osteoarthritis

S. Payano

1

Hospital Universitario Madrid Sanchinarro - Grupo Hospital

de Madrid, Oncologia Radioterápica, Madrid, Spain

1

, A. Montero Luis

1

, O. Hernando Requejo

1

, J.

Valero Albarran

1

, M. Lopez Gonzalez

1

, R. Ciervide Jurio

1

, E.

Sanchez Saugar

1

, X. Chen

1

, C. Rubio Rodriguez

1

Purpose or Objective:

The purpose of this study is to

evaluate the decrease in pain of patients treated with low-

dose radiation therapy in osteoarthritis.

Material and Methods:

From April 2015 to September 2015,

11 patients (10 female and 1 men) were treated with low

dose radiotherapy for pain control. All patients were

refractory to conventional therapy prior to irradiation.

13 joints (6 bursitis and 7 arthrosis): 4 trochanteritis, 5

knees, 1 left thumb rhizarthrosis, 2 metacarpophalangeal

joint and 1 right epicondylitis were treated.

The median age was 69 years (range 46-89) with a median

follow-up period of 3 months (range 0-6). Painful status was

measured by visual analogue scale (VAS), with a median pre-

treatment value of VAS= 7(range 4-9).

The radiotherapy dose of 6 Gy was delivered in 6 alternate

days fractions of 1 Gy per fraction. In those patient with no

pain relive post-treatment with VAS of or above 6 a second

course of radiotherapy was proposed.

The second RT series started 8 weeks after the first RT

series.

Results:

The analysis was performed before the treatment

and at the last follow-up. With a median VAS = 5 (range 0-8)

7 patients achieved pain relief, 3 patients underwent a

second course of radiotherapy with identical dose, and 1

patient showed no change in pain. Daily requirements of

analgesic were removed of reduced in 5 patients, subjective

pain perception of response to irradiation evaluated at time

of last visit regarding pre-treatment status was considered as

“better” by 73% of patient. No patients presented acute or

late complications attribute to radiation therapy.